On February 21, 2012, the ERS Board of Trustees agreed to enter into contract negotiations with United HealthCare Services, Inc. to serve as the third party administrator (TPA) for the self-funded HealthSelectSM of Texas health plan. United HealthCare Services, Inc. call center and claims processing unit is located in San Antonio, Texas.
ERS rebids Texas Employees Group Benefits Program (GBP) contracts regularly to ensure members get quality benefits at a reasonable cost. United was selected after a rigorous eight-month selection process. “We made a careful decision considering the importance of the health plan to the 438,570 employees, retirees, and their dependents who are members of the plan. United was selected for their winning combination of programs, services, and low administrative fee.” said Ann Bishop, Executive Director of ERS. “The program savings benefit members by offsetting ever increasing medical costs.”
HealthSelect is a self-funded managed care point-of-service (POS) plan. This allows the ERS Board of Trustees to control the benefits covered by HealthSelect within the funding available. Because ERS controls the plan design, a change in administrator does not mean that the benefits will change. The HealthSelect administrator is contracted to pay claims, provide customer service, offer health and wellness programs, and manage the HealthSelect provider network.
The new contract is expected to save $41 million. Saving money for the program benefits all HealthSelect members. It helps to offset the rising cost of medical care. While it can help to lower the rate of contribution increases and the need for design changes that shift costs to members, it will not prevent these types of changes.
Network disruption is expected to be minimal as well. ERS projects that about 2% of HealthSelect members might want to choose a new primary care physician (PCP) if their current PCP decides not to join. HealthSelect members can link to the online search tool for the United HealthCare Choice Plus network (9th option) to find out if their doctor is in the network.
The prescription drug plan stays the same and continues to be administered by Caremark.
HealthSelect members do not need to take any action. They will automatically receive a new HealthSelect ID card before the next plan year starts on September 1, 2012.